Our apathy is killing the NHS

It will last as long as there are folk left with the faith to fight for it.

Aneurin Bevan 1948 On the NHS

Sadly Bevan was wrong on his appraisal of the longevity of the NHS. For the NHS is in serious jeopardy at a time when the majority of us still have faith in it. In fact the NHS is the one institution the people of Great Briton are most proud of. We cherish it above the Army, the Royals and our sporting heroes. Love for the service is widely held and it is a love that cuts through race, gender and wealth. Bevan, maybe not surprisingly, so close to the end of the Second World War, made the mistake of presuming that Britons would always stand up and fight for what they believe in. He presumed that mere faith was enough. He would be shocked to learn that the vast majority of the population facilitated the demise of his great institution. Or a least stood back and allowed it to be sold off without as much as a whimper.

Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain

Jeremy Hunt 2005 On the NHS

That we allow the people who openly want to dismantle our beloved institution to control it, is a measure of how pliant we have become. A demarcation of just how low we have sunk in the eyes of the establishment. How easy it is to distract us with flat pack furniture, dancing dogs, immigrants and terrorists. Sixty Five million of us live here and barely a handful can can muster the conviction to put down our ready-meals long enough to ingest what is happening. Waddling from sofa to desk and back again, safe in the knowledge that the NHS will be there to salve the ailments caused by our sedentary nature. We have developed apathetic habits which pressurise the system, creating needless, costly and premature illnesses. But which also facilitate the conditions in which a series of governments can slowly privatise our cherished healthcare system without hardy any of us even batting an eyelid.

Despite all evidence to the contrary we take it for granted the the NHS will always be with us, from cradle to grave, based on clinical need and free at the point of use.

At least New Labour spun us some redemptive yarn when they began the process of turning the NHS into a corporate logo. The beatific glow hid the real intentions of Blair, Milburn and Reid, those who created the business like Foundation Trusts and introduced private treatment centres, the saintly initiators of the PFI contracts that currently dangle like gravestones around the necks of NHS budgets. The architects of Monitor, the body now set to oversee the final stage of the firesale. You could forgive an electorate for subjecting their most prized institution to the cloaks and daggers of the Blairites…

But the Tories?

Whose main policy maker is Oliver Letwin, a close friend of Cameron who in 1988 along with John Redwood wrote the blueprint for the current reform. His pamphlet, “Britain’s Biggest Enterprise: Ideas for Radical Reform in the NHS” (which I have embedded below) even goes as far as to note that changes should be carried out gradually in order to placate the public. The same man once bragged at a public meeting that the NHS would not survive 5 years of a Tory Government. The same man wrote a book called “Privatising The World” in which he advised that in order to move public services into the private sector it is beneficial if they are underfunded and run down for a period beforehand.

Understanding this ideology is the only way to make sense of the government’s behaviour during their confrontation with junior doctors. Why would the biggest believers in free market capitalism incentivise some of our most important and highly trained citizens to go and work in other countries? The answer is that this is exactly what they want them to do because the more broken it is the easier it is to privatise. And they want the doctors who choose to remain to be demoralised and tied to contracts that contain conditions more palatable to the private sector.

And it’s not like the politicians don’t have much to gain – one of the consequences of the changes started by New Labour is that there is now a revolving door between the civil services, the government and big business. The number of our lawmakers who have links to private health firms is an affront to democracy. The magnitude of the NHS contracts that are brazenly sold off to firms that are linked to our lawmakers is an affront to human decency.

The Health and Social Care Act 2012 was the penultimate straw, as in Letwin’s manifesto the NHS has now been separated from the state. The Foundation Trusts have been replaced by GP led commissioning groups, their remit to award contracts in tendering processes that are open to the private sector. Since the act was passed private companies have won more than half of NHS contracts in England. They pick and choose the most profitable parts leaving the difficult costly services for the state to deal with.

If the Health and Social Care Act was the penultimate move, the death knell will be Brexit. At the moment tendering is meant to award contracts based on quality, not cost. However, Brexit will open the door to TTIP style trade deals which will enable companies to sue governments for decisions they deem to have hurt their profit margins. Post Brexit trade deals will also pave the way to the homogenisation of standards between here and countries like the USA.

There is currently a precautionary principle applied to EU policies. If an action may cause harm to the public or the environment in the EU, science has to say otherwise for the action to become law. The Tory government were key cheerleaders for the failed TTIP and they will be quick to implement a similar deal for the UK.

This homogenisation of standards with the USA is interesting as other than the enrichment of the establishment there is no logical reason we would want to have a health service like the one in America. It spends much more money than us as a percentage of GDP and all for poorer outcomes. In fact, the UK system is one of the best in the world even though it spends less on health in comparison to our developed European neighbours. In short, we could solve many of our problems by spending a comparable amount to Germany or France. Not to mention by spending a vast amount more in keeping people healthy in the first place.

Saying that, the vast majority of us have no excuse for our poor health and the stress we are placing on the NHS except for apathy.

What the NHS in England needs now is for this abdication of responsibility to be reversed. Not only in terms of the positive health outcomes that individuals claiming liability for their own well-being may produce. But we need to rise up to halt the dangerous momentum dragging the NHS towards the precipice of full privatisation. Are we really going to sit back and watch as our most cherished and iconic institution is broken up and shared among the cronies of our ruling classes? Or will we shake off our stupor and stand up for what we believe in? There are more than enough of us left with the faith to fight for the NHS. But are there enough of us with the resolve?

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